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CNN Sunday Morning

Interview With Ron Petersen

Aired August 11, 2002 - 11:38   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

KRIS OSBORN, CNN ANCHOR: Two celebrities this week have announced their fight against a debilitating disease. Many saw Charlton Heston say he's suffering symptoms consistent with Alzheimer's disease. Heston made the announcement Friday.
We also learned this week, that the creator of "Dear Abby," Pauline Phillips, has been diagnosed with Alzheimer's. Joining us now to discuss is Mrs. Phillips' doctor, Dr. Ron Peterson. He also treats Ronald Reagan and heads the Mayo Alzheimer's disease research center. Dr. Peterson is in Rochester, Minnesota. Hello, doctor.

DR. RON PETERSEN, MAYO ALZHEIMER'S RESEARCH CENTER: Good morning.

OSBORN: I want to begin by asking you, of course, you have medical confidentiality concerns, but want to know what you can tell us about how the former president Ronald Reagan, and of course, Pauline Phillips, "Dear Abby," is doing.

PETERSEN: Well, President Reagan is progressing as other individuals with the disease, and as we've discussed previously, it's pretty much a typical course of Alzheimer's disease.

With respect to Abby, she became symptomatic approximately two or three years ago, but because she's such a high functioning person, and remains high functioning, she's really doing quite well. So, to the casual observer, one would not know anything was wrong with Abby, but in fact her family and friends have been aware of some symptoms for the past couple of years.

OSBORN: Well, doctor, let's talk about some of those symptoms -- language, some memory issues, of course, loss of initiative -- how is it that you can go about making a diagnosis of these symptoms?

PETERSEN: Well, the diagnosis of Alzheimer's disease is still a clinical diagnosis, and by that I mean there is no definitive test. There's no blood test, there's no X-ray examinations that will say yes or no, but rather it's the judgment of the physician who sees the patient. But the physicians have become quite accurate in recent years.

So, usually what we look for is a change in performance; meaning whatever the person was formerly doing, there's now a change in that level of function, due to their thinking abilities.

So, if they're somewhat forgetful, they have difficulty coming up with the right word, they have difficulties with problems solving, and this is affecting their daily living now, we feel that this might be a gradually progressing dementia. And the dementia then, if it's felt to be due to a degenerative disease of the brain, is likely to be Alzheimer's disease.

OSBORN: Well, you mentioned early signs of some cognitive difficulties, so then, I understand that prevention is very much where treatment of all Alzheimer's is looking to go?

PETERSEN: That's right, Kris. The emphasis of research in Alzheimer's disease today is toward prevention. The feeling is that by the time the symptoms have developed, the patient has been diagnosed with Alzheimer's disease, there may be too much destruction done in the brain to really reverse it. So, the efforts are being placed in prevention of the disease, both on the clinical or the patient-oriented side of research, as well as the basic science or laboratory side.

So, on the patient-oriented side of research, we're trying to identify the earliest signs, symptoms, memory impairments that might lead to Alzheimer's disease. On the basic science or laboratory side, researchers are working on development of tests for the protein that is deposited in the brain and cause the destruction that leads to symptoms of Alzheimer's disease.

Ultimately, we hope that these two forms of research will converge, such that we'll be able to design drugs or other therapeutic interventions that may have an impact on that protein that gets developed and deposited in the brain, and in fact we'll be able to treat patients at the earliest stage, and prevent the disease.

OSBORN: Well, doctor, you mentioned that "Dear Abby" was functioning very well, in many respects. Given that, what would the prognosis be for Charlton Heston -- he -- you know, wants to continue to work, wants to continue to function. It's certainly conceivable that he could function for quite a while.

PETERSEN: Well, its difficult for me to comment on Mr. Heston personally since I have not been involved in his care, but in general, people can perform quite well for many years into the early stages of the disease. They can interact socially and interact professionally, and remain quite active.

So, the disease is not necessarily a rapid downhill progression, but they can be rather long prodromal (ph) stages of the disease with progression of the symptoms over many years.

Someone recently put it me that, in terms of coming to a sense of what might be symptoms consistent with Alzheimer's that if you forget where your glasses are, that's not Alzheimer's, but if you forget you wear glasses, well, that could be symptoms consistent with the disease.

PETERSEN: Well, that's right. The early stages of the disease may, in fact, have rather insidious onset, and -- in terms of the memory impairment. So, the early stages of Alzheimer's disease, perhaps even before the diagnosis of Alzheimer's disease is made, considers a condition know as mild cognitive impairment.

In mild cognitive impairment, people have a memory impairment that is more pronounced than they ought to have for their age, yet their other areas of function -- their language abilities, their reasoning skills, problem solving -- are fairly well intact. These people are normal with regard to their activities in the community -- they're driving, they're paying their bills, doing their taxes -- but they're more memory impaired than they used to be.

This may be, in fact, the very earliest stages of a condition that may develop into Alzheimer's disease, and there are features of the memory impairment that allow us to make that distinction.

OSBORN: Well, lastly, doctor, I wanted to ask you about the percentages. I heard our own Dr. Gupta say that 85 and over, the percentages for those who get these symptoms consistent with Alzheimer's are pretty high, close to 50 percent.

PETERSEN: That's right; it is very much an age-related disease. It's quite uncommon early in life. So in the 50s, it's very rare, except for some rare familial cases with known genetic mutations. In the 60s, it's still quite uncommon, but in the 70s and 80s it goes up rather dramatically. And there are varying figures that indicate that people in their 80s may have a one-third to a one-in-two chance of having the disease especially as they get into the late 80s.

OSBORN: Dr. Petersen, thank you very much for your perspective on this issue that of course many are very concerned about right now.

PETERSEN: Thank you.

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